Doctor wished to include Savita in medical trial

The husband of Savita Halappanavar was approached by a doctor as his wife lay critically ill in hospital to get permission to include her in a medical trial being conducted in Britain.

Praveen Halappanavar said he was disappointed and uncomfortable with what he was being asked, just two days before his wife died. When he questioned the doctor, the medic said he did not know if the trial was approved by the Irish Medicines Board.

Mrs Halappanavar, 31, was 17 weeks pregnant when she miscarried at Galway University Hospital. She died unexpectedly from septic shock and an E.coli infection on Oct 28 last year — six days after being admitted.

Her husband had maintained since her death that three requests for a termination had been refused by the hospital medical staff after it emerged the foetus had no chance of survival.

A distressed Mr Halappanavar, in an 18-page statement which he read to his wife’s resumed inquest in Galway yesterday, told of being approached for permission to include his wife in the trial on Friday, Oct 26. His wife had miscarried a baby girl and was described as "critically stable" at the high dependency unit at the hospital.

On the morning, a doctor came to him in the hospital and sympathised with him on the loss of his baby. He asked if he was OK to chat and advised him that his wife was in septic shock.

The doctor said he was working on a trial in Britain and wondered if Mr Halappanavar would agree to have Savita included in the trial.

"I asked if it was approved by the Irish Medical Board and he said he was not sure," said Mr Halappanavar. While the doctor then sent his assistant to check this out, Mr Halappanavar asked about possible side effects. The doctor replied that some patients had experienced problems, but that one other patient in the intensive care unit was already on the medication.

"I was not comfortable with it, but he said it would help other patients in the future. This was not what I was expecting. I thought the meeting was about Savita’s health and I was very disappointed," he said.

Later, Declan Buckley, for the HSE and the hospital, told Mr Halappanavar that Dr Michael Scully was the doctor who had spoken to him about the trial. Dr Scully was involved in a trial dealing with sudden respiratory distress syndrome. Mr Buckley said that if the approach came across as clumsy, then Dr Scully would be upset that Mr Halappanavar would be upset about it.

Mr Halappanavar insisted that on three occasions between Oct 22 and Oct 23, his wife had requested a termination after they had been told the baby had no chance of survival.

His wife had twice asked obstetrician Dr Katherine Astbury to terminate on Oct 22, but she had been told that unfortunately she could not as "this is a Catholic country.". While the foetus was alive, she could not terminate.

On a further occasion, while he was not present, he was aware that his wife had again requested a termination, but received the same answer.

Mrs Halappanavar subsequently miscarried, but her health deteriorated and she died on Oct 28.

Under cross-examination, Mr Halappanavar acknowledged he may have mixed up the date of one of the termination requests after it emerged that Dr Astbury could not have been present with his wife.

Mr Buckley said Dr Astbury would give evidence that Mrs Halappanavar only once requested a termination, but that there was no reason to consider such a course as there was no risk to her health at that time.

A friend of Mr Halappanavar, Chalikonda Prasad, an orthopaedic consultant surgeon, was present with others when Mrs Hallapanavar died.

When his friend had told him about his wife’s critical situation, he had asked why staff had not terminated the pregnancy. Mr Halappanavar told him repeatedly they could not because it was a Catholic country. This prompted him to consult with colleagues. He also consulted the Medical Council guidelines. He said the guidelines stated that where there was little or no hope of the baby surviving, it may be necessary to terminate the pregnancy to protect the life of the mother.

The inquest continues.

This story appeared in the printed version of the Irish Examiner Tuesday, April 09, 2013